Meniere’s Disease | Pathophysiology, Triggers, Symptoms, Diagnosis, Treatment
Meniere’s Disease is an inner ear disorder involving recurrent and spontaneous episodes of vertigo (sensation of room spinning) with other associated symptoms. The etiology behind Meniere’s disease is not known; however, it is believed to be related to genetic predisposition and the presence of other medical conditions. Meniere’s disease causes a variety of signs and symptoms, including changes in hearing and these symptoms can be triggered by a variety of dietary factors. In this lesson, we discuss all of these details, including how it is diagnosed and how it is treated.
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At some point in your life, you have likely experienced dizziness. Now there are a variety of things that can give you the sensation of being dizzy, but one of the worst is a condition called Menieres disease. With Meniere’s Disease, not only do you get dizzy, but it can also cause tinnitus, ear fullness, ear congestion, and fluctuating hearing loss.
According to the US National Library of Medicine, Menieres Disease affects over 600,000 people in the United States alone with over 45,000 new diagnoses each year. If you have ever had Vertigo, which is an episode of intense dizziness, combined with tinnitus, ear fullness, ear congestion, and fluctuating hearing loss.
Menieres disease usually affects only one ear but can progress to your other ear over time, and while the sensation of vertigo doesn’t last forever, it can have a long-lasting effect on your hearing.
So what causes Menieres Disease? To understand exactly where the fluid buildup is occcuring, we have to understand the anatomy of the human ear. First, we have the outer ear which is the Pina and the Ear Canal.
Then we have the Middle ear which consists of the Eardrum, the 3 bones of hearing, known as the Ossicles, the Eustachian Tube, and the Middle ear Space.
The Inner ear consists of the Cochlea which is responsible for hearing, and the Semicircular Canals which are responsible for Balance.
Menieres Disease is thought to be related to a buildup of fluid in your Inner Ear. It is important to note that fluid buildup in the Inner ear is different than the fluid buildup in your Middle Ear which may be caused by an Ear Infection.
This buildup of fluid in the Inner Ear causes a disruption in how the cochlea, vestibular system, communicate with your brain. Which is why you typically have symptoms that involve Balance and Hearing at the same time.
In normal circumstances, your brain expects to receive similar information from both of your ears. It is this mismatch of signals between your affected ear and your non-affected ear that cause you to feel dizzy.
That being said, no one knows for sure exactly what causes Menieres Disease. Some researchers believe it could also be tied to blood vessel constriction, viral infections, allergies, autoimmune reactions, or genetic factors. Episodes of Menieres Disease may be triggered by being tired, emotional distress, dietary factors, and stress in general.
Menieres attacks can occur at random sometimes with several episodes in a short period of time, or in some cases, months between episodes. It is often diagnosed by an Ear, Nose & Throat Physician. It can occur at any age, but is most common in adults between the ages of 40-50 years old.
Since there is no Gold Standard test for Menieres disease, physicians typically look at your Medical History to identify symptoms such as two or more episodes of vertigo lasting 20 minutes each, an onset of “roaring” tinnitus, hearing loss in the low frequencies, and a feeling of aural or ear fullness. You physician will likely order some additional testing to support the diagnosis to include a hearing test, vestibular or balance testing, and even an MRI or CT scan to rule out other possible medical conditions.
When it comes to treating your dizziness, individuals typically manage these symptoms with medications and dietary changes. Medications prescribed by your physician may include Meclizine, Diazepam, & Lorazepam to reduce the effects of dizziness, nausea, and anxiety. They may also include a diuretic to reduce fluid buildup in the inner ear. Dietary modifications can include reducing the intake of salt, chocolate, caffeine, and alcohol which can all trigger a Menieres attack. You may also benefit from vestibular rehabilitation administered by a specially trained physical therapist. Hearing loss and tinnitus symptoms can often be treated successfully with hearing aids by an audiologist once your hearing loss stabilizes.
Menieres Disese is no joke so if you ever experience dizziness or vertigo along with hearing loss, tinnitus, and ear fullness, make sure you see your physician right away so you can find a treatment solution that is right for you.
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